Different Kinds Of Loneliness – Having Poor Quality Relationships Is Associated With Greater Distress Than Having Too Few

Loneliness not only feels bad, experts have characterised it as a disease that increases the risk of a range of physical and psychological disorders. Some national prevalence estimates for loneliness are alarming. Although they can be as low as 4.4 per cent (in Azerbaijan), in other countries (such as Denmark) as many as 20 per cent of adults report being either moderately or severely lonely.

However, there’s no established way of identifying loneliness. Most diagnostic methods treat it as a one-dimensional construct: though it can vary in degrees, someone is either “lonely”, or they’re not. A new approach, outlined in a paper published recently in Social Psychiatry and Psychiatric Epidemiology, suggests that loneliness should in fact be divided into three sub-types, two of which are associated with poor mental health.



Philip Hyland at Trinity College Dublin and colleagues studied a nationally representative sample of 1,839 US adults aged between 18 and 70, all of whom had experienced at least one traumatic event in their lifetime. (This allowed the team to also look for associations between childhood or adult trauma and loneliness.) Most were married or living with a partner.

Participants completed a six-item scale that measured feelings of “social loneliness” (focusing on perceptions of the quantity of one’s social relationships) and “emotional loneliness” (which focused on perceptions of the quality of one’s relationships). They also completed questionnaires assessing levels of childhood and adult trauma, depression and anxiety, and their psychological wellbeing.

Following convention, the 17.1 per cent of participants who scored a certain amount above the average loneliness score for the sample (by more than one standard deviation) were classified as “lonely” – a figure comparable to that found previously in many other countries.

However, the researchers also used a statistical technique to look for qualitative differences between the participants’ loneliness responses, and this revealed four distinct classes.

The first class – which they called “low loneliness” – was characterised by low scores on both types of loneliness, social and emotional. Just over half the participants fell into this category. The second class – “social loneliness” – making up 8.2 per cent of the sample, comprised people low on emotional loneliness, but high on social loneliness. The third class – “emotional loneliness” – made up just over a quarter of the total sample and was characterised by the opposite pattern of high emotional loneliness but low levels of social loneliness. People in the fourth and final “social and emotional loneliness” class, accounting for 12.4 per cent of the sample, scored high for both types of loneliness.

The researchers found a clear gradient of psychological distress across the classes. People in the low loneliness class were, predictably, least distressed, followed by people in the “social loneliness” class, then the “emotional loneliness” class, and finally the “social and emotional loneliness” class. In fact, people in both these last two classes had levels of symptoms of depression, anxiety and negative psychological wellbeing that were reflective of a psychiatric disorder.

In other words, quality of relationships appears more important to mental health than the sheer number of them.“These results indicate that while the experience of social loneliness is associated with slight diminutions in overall mental health, relative to the low loneliness class, the experience of emotional loneliness has a substantially greater, and more negative impact on overall mental health status,” the researchers write. “The combination of social and emotional loneliness is associated with the poorest mental health status,” they note.

People who belonged to the emotional loneliness class were more likely to be female, younger than average for the group, not in a relationship and to have suffered an increased number of childhood traumas. (Every childhood traumatic experience increased the odds of belonging to the emotional loneliness class by 28 per cent.) The same associations were true for the “social and emotional” loneliness class – except they were also characterised by a greater number of adult traumas.

At 39.0 per cent, the total percentage of participants who fell into the two loneliness classes characterised by clinically relevant levels of psychological distress was much higher than the 17.1 per cent loneliness figure obtained using the conventional one-dimensional approach. “This finding indicates that by recognising naturally occurring subtypes of loneliness, the number of people experiencing a form… that is likely to be of clinical relevance is more than double the number identified when loneliness is conceptualised as a unidimensional construct,” the researchers note.

The work suggests that in assessing loneliness, whether in an individual or at a national level, it’s important to recognise there are various subtypes. It also supports findings from some other studies that it’s the quality, not quantity, of your relationships that really matters. As the researchers conclude: “From a societal perspective, and in the interests of reducing the burden of psychological distress, efforts should be made to enhance the quality of social connections as opposed to promoting the virtues of larger social networks.”

SOURCE:

https://digest.bps.org.uk/2019/02/20/different-kinds-of-loneliness-having-poor-quality-relationships-is-associated-with-a-greater-toll-than-having-too-few/(accessed 4.3.19)

Being true to yourself may protect against the harmful effects of loneliness

A lot has been written about the downward spiral of loneliness. People who crave more social contact often develop behaviours and thinking styles that only serve to accentuate their isolation, such as turning to drink and becoming more sensitive to perceived slights and rejections. Less studied is the question of whether some people have personality traits that give them a buffer against these loneliness-related risks. A new study published in the Journal of Health Psychology finds a promising candidate that appears to fit this description – authenticity, or being true to yourself.

Jennifer Bryan and her colleagues surveyed 537 undergrads (average age 22; age range 18 to 60), nearly three quarters of whom were female. The students filled out questionnaires about how lonely they felt; their mood; any unpleasant physical symptoms they'd experienced in the last month; how much alcohol they typically drank on a daily basis and whether they had a drink problem; and finally their authenticity.

To get a sense of what the researchers really mean by "authenticity" let's look in more detail at that last questionnaire. It consisted of 45-items in four categories: Awareness, which means how much someone is motivated to understand themselves (points are awarded for agreement with statements like "For better or worse I am aware of who I truly am"); Behaviour, which measures how much the person actually acts in accordance with their values and beliefs; Related Orientations, which is about how open and honest the person is in their relationships; and finally, Unbiased Processing, which speaks to how much someone can accurately evaluate themselves without being misled by what other people say or do. The researchers averaged across these subscales to give their participants an overall authenticity score.

The main result is straightforward. Across the whole group of students, feeling more lonely tended to correlate with being feeling more depressed and anxious; having more physical symptoms and more drink problems. Sadly, this is consistent with prior research on the sequelae of loneliness. But here's the thing: among those students who scored more highly on authenticity, these associations were all reduced. That is, if you felt lonely but you also scored highly on authenticity, then your depression and anxiety tended to be lower, so too your drink problems and physical symptoms.

This is a cross-sectional study – it only involved taking measures at one point in time – so we need to interpret the results with caution (we also don't know if the same findings would apply to a different demographic group, such as elderly people). But one hopeful interpretation of these results is that being true to yourself provides a kind of protection against the usual negative effects of being lonely.

Why might this be? Bryan and her colleagues posit a couple of explanations: First, perhaps highly authentic people don't overanalyse their lonely feelings – they don't see their loneliness as some kind of indictment of their personality, it's just the way things currently are. Second, authentic people are likely less inclined to try to get out of their lonely situation by hanging out with people they don't want to be with, or doing stuff they don't want to do. Yes, this might increase their isolation at first, but it probably helps prevent them from growing more bitter and resorting to counter-productive coping mechanisms like drinking too much.

Of course there's a lot of speculation here. We need a replication of the finding with a more robust longitudinal research methodology (that follows people's changing feelings and traits over time), and to test other demographics. What's exciting though, is that if the effect proves to be real, then it hints at a useful way to help lonely people – simply encourage them to be true to themselves. "Such an intervention would be uniquely beneficial," the researchers said, "as it would not require effort from others (who need to interact with the lonely individual)."

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SOURCE:

http://digest.bps.org.uk/2015/11/being-true-to-yourself-may-protect.html(accessed 28.11.15)

Bryan, J., Baker, Z., & Tou, R. (2015). Prevent the blue, be true to you: Authenticity buffers the negative impact of loneliness on alcohol-related problems, physical symptoms, and depressive and anxiety symptoms Journal of Health Psychology DOI:10.1177/1359105315609090

Loneliness is a disease that changes the brain's structure and function

Loneliness increases the risk of poor sleep, higher blood pressure, cognitive and immune decline, depression, and ultimately an earlier death. Why? The traditional explanation is that lonely people lack life’s advisors: people who encourage healthy behaviours and curb unhealthy ones. If so, we should invest in pamphlets, adverts and GP advice: ignorance is the true disease, loneliness just a symptom.

But this can’t be the full story. Introverts with small networks aren’t at especial health risk, and people with an objectively full social life can feel lonely and suffer the consequences. A new review argues that for the 800,000 UK citizens who experience it all or most of the time, loneliness itself is the disease: it directly alters our perception, our thoughts, and the very structure and chemistry of our brains. The authors – loneliness expert John Cacioppo, his wife Stephanie Cacioppo, and their colleague John Capitanio – build their case on psychological and neuroscientific research, together with animal studies that help show loneliness really is the cause, not just the consequence, of various mental and physical effects.

The review suggests lonely people are sensitive to negative social outcomes and accordingly their responses in social settings are dampened. We know the former from reaction time tasks involving negative social words (lonely people respond faster), and tasks involving the detection of concealed pain in faces (lonely people are extra sensitive when the faces are dislikeable). Functional imaging evidence also shows lonely people have a suppressed neural response to rewarding social stimuli, which reduces their excitement about possible social contact; they also have dampened activity in brain areas involved in predicting what others are thinking – possibly a defence mechanism based on the idea that it’s better not to know. All this adds up to what the authors characterise as a social "self-preservation mode."

Meanwhile, animal models are helping us to understand the deeper, biological correlates associated with loneliness. For mice, being raised in isolation depletes key neurosteroids including one involved in aggression; it reduces brain myelination, which is vital to brain plasticity and may account for the social withdrawal and inflexibility seen in isolated animals; and it can influence gene expression linked to anxious behaviours.

What about changes to our neural tissue? Human research is suggestive: in one study, people who self-identified as lonelier were more likely to develop dementia. Here, initial cognitive decline could be causing loneliness, but animal work gives us some plausible mechanisms for loneliness’ impact: animals kept in isolation have suppressed growth of new neurons in areas relating to communication and memory, just as very social periods such as breeding season see a pronounced spike in growth.

Other basic brain processes are also upset by isolation. Isolated mice show reduced delta-wave activity during deep sleep; and their inflammatory responses also change, meaning that in one study, three in five isolated mice died following an induced stroke, whereas every one of their cage-sharing peers survived the same process.

The research is clear that loneliness directly impacts health, so we need to do what we can to help people free themselves from social marginalisation. I’ve seen one approach during my time serving with time banking charities, in which people give their own time in return for someone else’s in a different situation – a process that can build social networks. Also the issue is acquiring momentum through the Campaign to End Loneliness and technology solutions such as the RSA’s Social Mirror project – an app that tells people about local social groups and activities. Mainstream health is also picking this up under the term “social prescription” (physicians advise patients of social groups and activities and “facilitators” help the patients take up the opportunities). But amongst all the institutional activity, we mustn’t forget our individual duties: sometimes all that’s needed is to reach out.

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SOURCE:

http://digest.bps.org.uk/2014/11/loneliness-is-disease-that-changes.html?utm_source=BPS_Lyris_email&utm_medium=email&utm_campaign=Newsletter(accessed 5.12.14)

Cacioppo, S., Capitanio, J., & Cacioppo, J. (2014). Toward a neurology of loneliness. Psychological Bulletin, 140 (6), 1464-1504 DOI: 10.1037/a0037618